Year Six of Hope & Change

It was a bittersweet briefing that told us exactly where the Obama administration finds itself at the dawn of its sixth year.

When a group of senior officials gathered last week to tout President Obama's efforts to make college a realistic possibility for low-income students, they were genuinely enthusiastic about the agreements they had brokered with university presidents and foundations to tear down some of the barriers to poor and minority kids. They spoke of waiving the fees that keep those with few resources from applying to multiple schools, a choice that those in upper-middle-class families exercise freely. They described steps to close the huge gaps between the well-off and the needy in test preparation and college advising. They talked about how more students could cross the threshold of opportunity if they had more information about scholarship help and received regular reminders about deadlines through cellphone messages.

All were good ideas that even devout conservatives could praise. None required action by Congress. None involved spending new public money to reduce the inequities the briefers mourned with such passion.

"In a perfect world, we'd be investing hundreds of million more," one of the officials said. "That's not the hand we've been dealt."

On Jan. 20, 2009, the cards Obama was holding looked very different. "On this day," Obama declared in his inaugural address before a euphoric crowd of 1.8 million, "we come to proclaim an end to the petty grievances and false promises, the recriminations and worn-out dogmas that for far too long have strangled our politics."

Six years later, politics has strangled many of those hopes. For those who say there can be a separation between politics and policy, between aspiration and grubby reality, the results of the 2010 midterm election stand as a rebuke. Hope and change of the sort Obama had in mind suffered a hard blow when Republicans assumed control of the House of Representatives, enhanced their blocking power in the Senate and won themselves the ability to draw generally friendly legislative boundaries.

It's true that the last several weeks have allowed Obama to stage something of a comeback from the low point he reached after the collapse of the website that was supposed to ease the way to health insurance coverage for millions of Americans.

Obamacare is now working more smoothly than those who wrongly predicted its inevitable demise thought possible. Some Republicans are even proposing fixing the law rather than killing it.

In the absence of health care horror stories, the president has been able to put some of his own concerns back on the public agenda with his moving news conference last Thursday on those college access plans and his unveiling of modest initiatives on behalf of manufacturing. Republicans seem to have pulled away from strategies that produced chaos in the budgeting process, and Congress even passed a normal spending bill. On Friday, the president announced reforms of how the National Security Agency collects and uses telephone records.

And the nation's political conversation has been shifting toward issues Obama has always wanted to highlight. Even conservatives are now acknowledging declining social mobility, rising inequality and the persistence of poverty. And, yes, immigration reform is still a possibility.

But the prime mover behind the NSA changes was not the president but Edward Snowden, whose leaks unleashed a public demand for reform. As for the budget, it may be "normal," but it still leaves little room for the steps Obama knows the country needs to take to be more productive and more just.

And so Obama once again has to make the argument he thought he won not only in 2008 but also in 2012. Politics is very much back in the saddle -- and in truth, it never left. The outcome of this November's elections will have a lot to do with whether he gets one more chance at redeeming the promissory note he issued on that January day in 2009.

If the sole criterion for judging the last five years is whether the country is better off than it was when Obama first raised his hand, the answer is clearly yes. The economy and the health system are on stronger ground. But Obama lifted hopes about politics that transcend this most basic test of his stewardship. He underestimated the ferociousness of the opposition he would face and the importance of constantly cultivating allies. He's now obligated to harness his new realism to a final try at fulfilling his larger pledge.

Comments

The GOP could have negotiated important concessions, in exchange for bipartisan support of Obamacare. Hyde amendment guarantee of no funding for abortions? Check. Employer opt outs for contraception? Check. Congressional approval and oversight? Check.

Instead, the strategy was to oppose and criticize. At the state level, eschewing the opportunity to relieve the burden on local hospitals for indigent care through accepting Federal dollars for Medicaid expansion is foolish cutting off of the nose to spite the face.

The question is how strongly the economy recovers over the next nine months and whether Obamacare transitions from a liability to at least neutral. I hope that the Catholic bishops heed the admonishment of the Pope to be more pastoral and less political. I think that historians will be more kind to Obama than to his uncompromising opponents. - Larry Weisenthal/Huntington Beach CA

A sad post by E.J. Dionne, yet still with a glimmer - repeat, glimmer - of hope for the next couple of years. And I wholehearted agree with you, Mr. Weisenthal. Most Americans likely do not know that, the very evening of Inauguration Day in 2008, following the President's inspiring words (quoted here) to the assembled 1.8 million on the National Mall, a group of GOP leaders met and resolved only to oppose this President. I fear that their decision -- and the lies, distortions and fearmongering that have followed -- may have harmed this country more than we realize. But I also believe that the hope the President inspired will continue beyond his presidency, and will inspire other leaders to continue his causes in the years to come.

There is plenty of criticism to go around. Reid and Pelosi were not the angels wanting to agree on partisanship when they controlled Congress. Obama was not the healer he promised to be. He made only superficial attempts to "bring parties together and to fix a broken Washington", a promise he has yet to keep. His behavior has been to play the victim and cow to the ever-ending rethoric of chastisment for anyone or party that disagrees with him. Don't get me wrong. I think he has good intentions. His judgment and actions I seriously question. Just wait 3 months and see how ObamaCare is hurting both the cost side and personal side of healthcare. It was sold as a $800 billion program that is now $2.7 Trillion and increasing. His supports just ignore this fact and tell everyone that it is a good program that is long overdo. I wll not go into the "you like you plan and doctor you can keep them....or that the average family of four will save $2500 a year. If you believe that I have a bridge in Brooklyn for sale.

Don't get me wrong, the Republican party is no angel. They have been far too criticial of Obama and few have attempted to be partisan. They lack a good leader as well. However, the President is the leader of the country and there is no room for the division that he himself fuels. Obama is not Bill Clinton or Ronald Regan. Clinton had the ability to move to the center, something I pray that Obama does after the 2014 Congressional elections where the Democrats might lose the Senate to the Republicans. Either way, our nation will be better off with better leadership from the President and all politicial leaders.

ObamaCare had to be rushed through Congress, because there was absolutely no willingness whatsoever on the part of the GOP to work to make the Affordable Care Act as good as it could be, coming out of the blocks. A universal health care program had been an elusive goal, since Theodore first proposed it a century ago. When Scott Brown won Ted Kennedy's old seat, the bill which had passed the Senate was the only legislation available. There was no possibility for an improved House version, nor for further changes in a subsequent Senate/House reconciliation conference. Had the GOP been at all interested in improving the bill, it could have readily done so. But they weren't interested in that. They wanted to see ObamaCare fail, and they wanted the opportunity to play the blame game.

As it is, there were major compromises to the conservative point of view. Many of us wished to have Medicare for all. Medicare is the most successful large scale health insurance program in the country. It provides universal coverage; it has by far the largest provider network; there are no gatekeepers, either bureaucratic or primary care, in the way of a patient and a specialist; the cost is substantially less than in the private sector; health care outcomes are unsurpassed; personal bankruptcies relating to health care costs are the least frequent; and consumer satisfaction is the greatest. If the GOP allowed Medicare to negotiate with drug companies and device manufacturers on price, cost would be even lower.

Instead, what we got was a plan which was first designed by the Heritage Foundation, endorsed by Grassley, Dole, and Gingrich (including the personal mandate), and first put into effect by Mitt Romney.

It was the same thing with the "stimulus." We didn't get infrastructure on the scale which was required; instead we got GOP-syle tax cuts accounting for a substantial portion of the entire stimulus, and the scope of the program was smaller than it should have been. All in a futile attempt to attract a modicum of GOP support.

David Brooks calls Obama a "moderate Democrat." That's what he is. He's not some radical Marxist. He's been the subject of unrelenting, withering criticism and obstructionism since he was first sworn into office. The number one goal of the GOP, as candidly stated by McConnell, was to make Obama "a one term President."

You paint a dismal picture of the future of ObamaCare. A certain sector of the media would have you believe that. But this is by no means a universal point of view:

Do you know why traditional fee for service health care doesn't work? It's because it doesn't follow the customary rules of an economic market. In health care, the sellers (doctors) make the most important (and most expensive) health care decisions for the buyers (patients). It's completely untenable. An overlooked aspect of ObamaCare is that it seeks to change the reimbursement model from fee for service to fee for outcomes. This is the approach favored also by former Minnesota GOP governor Tim Pawlenty, in his brief, aborted Presidential run. The launch of ObamaCare was anything but smooth and, as the saying goes, mistakes were made. But it did get launched, and it will get fixed, and I and others believe that it will yet work.

I spent more than 30 years in the healthcare business, was a senior partner at a worldwide healthcare consulting firm, then as a SVP for a major healthcare organziation. My problem with ObamaCare was that the Federal government underestimated its cost and overestimated its savings. I had no issue with healthcare for the poor, near poor and those who could not get affordable care. My issue was a profound ignorance on the part of ObamaCare designers about how the healthcare marketplace functions.

Some aspects of the ACA might work, while other aspects are highly suspect and I am being kind. I ask: At what price is the ACA affordable? At what price should we accept for universal healthcare? Every Democrate in Washington voted for the ACA at a cost of $800 billion. Today, the best estimate is now $2.7 Trillion. Aetna, one of most respected insurers in the U.S., may pull out from participating in the ACA, despite reassurances from Obama that insurers will be "bailed out" if the risk pool does not have enough young, healthy people in it. Frankly, no insurer really believes that such a promise is open-ended or that the so-called bail out process would be efficient, effective or fair. Neither will members of Congress want to bail out insurance companies.

The issue you raise, that the Republicans could have made the ACA better, but worked instead to defeat it, does not excuse the flawed design of this law. When the outcomes of the ACA are now unraveling, you cannot play the blame game. Independents and republicans and many democrats will run away from the ACA if further problems emerge.

Obama will not compromise because the fix or answers mean that the ACA will have to undergo a redesign of its underlying principles. This would entail a massive reconstruction. There are no quick fixes. So far, what we are witnessing now is what my experience and intuition told me years ago. I hope I am wrong and you are right.

About the Author

E. J. Dionne Jr. is a syndicated columnist, professor of government at Georgetown University, and a senior fellow at the Brookings Institution. His most recent book is Our Divided Political Heart: The Battle for the American Idea in an Age of Discontent (Bloomsbury Press).